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Anemia in CKD

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https://www.readbyqxmd.com/read/28507581/long-term-outcomes-in-children-with-chronic-kidney-disease-stage-5-over-the-last-40-years
#1
Dominika Adamczuk, Maria Roszkowska-Blaim
INTRODUCTION: We evaluated outcomes in children with chronic kidney disease stage 5 (CKD 5) treated in the first pediatric dialysis unit in Poland during 1973-2012. MATERIAL AND METHODS: The retrospective analysis included 208 children with CKD 5 undergoing renal replacement therapy (RRT), stratified into four decades of treatment: 1973-1982, 1983-1992, 1993-2002, and 2003-2012. RESULTS: The most common causes of CKD 5 included glomerulonephritis in 27...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28468297/hypoxia-hif-and-associated-signaling-networks-in-chronic-kidney-disease
#2
REVIEW
Jing Liu, Qingqing Wei, Chunyuan Guo, Guie Dong, Yu Liu, Chengyuan Tang, Zheng Dong
The pathogenesis of chronic kidney disease (CKD) is complex and apparently multifactorial. Hypoxia or decrease in oxygen supply in kidney tissues has been implicated in CKD. Hypoxia inducible factors (HIF) are a small family of transcription factors that are mainly responsive to hypoxia and mediate hypoxic response. HIF plays a critical role in renal fibrosis during CKD through the modulation of gene transcription, crosstalk with multiple signaling pathways, epithelial-mesenchymal transition, and epigenetic regulation...
April 30, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28457030/evaluation-of-effect-of-vitamin-d-deficiency-on-anemia-and-erythropoietin-hyporesponsiveness-in-patients-of-chronic-kidney-disease
#3
N Nand, R Mittal
BACKGROUND: The role of vitamin D deficiency and inflammation levels in renal anemia has been documented. However, no study is available in India where the role of vitamin D supplementation in patients with hyporesponsiveness to increased doses of erythropoietin is available. Hence this study. MATERIAL AND METHODS: This study was conducted on 50 adult patients of CKD, on regular, twice weekly hemodialysis. It included 38 cases in group A with deficient serum vitamin D levels (<30 ng/ml) and 12 cases in group B with sufficient vitamin D levels (>30 ng/ml)...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28457029/role-of-ace-and-il-1%C3%AE-gene-polymorphisms-in-erythropoeitin-hyporesponsive-patients-with-chronic-kidney-disease-with-anemia
#4
N Nand, A R Deshmukh, S Joshi, M P Sachdeva, Sakthivel
BACKGROUND: Hyporesponse to erythropoietin is a common problem seen in around 5-10% of patients. Recently the focus from these remediable factors has been shifted to the non-modifiable innate factors i.e polymorphism of ACE and IL-1B gene and studies have shown that DD genotype and IL-1B CC genotype have lower erythropoietin requirement. The aim of our study was to evaluate the role of ACE and IL-1B gene polymorphisms in erythropoietin hyporesponse in CKD patients with anemia. METHODS: A total of 50 patients were selected...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28446125/soluble-transferrin-receptor-as-a-marker-of-erythropoiesis-in-patients-undergoing-high-flux-hemodialysis
#5
Pei Yin, Jijun Li, Yan Song
Anemia is a common complication in chronic kidney disease (CKD) patients receiving hemodialysis. The effect of high-flux dialysis (HFD) on anemia remains unclear. This prospective study aimed to evaluate the effect of HFD on anemia, and the potential of soluble transferrin receptor (sTfR) as a marker of iron status and erythropoiesis in CKD patients on hemodialysis. Forty patients, who switched from conventional low-flux dialysis to HFD for 12 months, were enrolled in this study. The levels of sTfR, hemoglobin, iron, and nutritional markers, as well as the dose of recombinant human erythropoietin (rhEPO) and use of chalybeate were determined at 0, 2, 6, and 12 months after starting HFD...
April 27, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28436206/clinical-practice-guidelines-on-iron-therapy-a-critical-evaluation
#6
REVIEW
Lucia Del Vecchio, Francesco Locatelli
Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide. Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28417130/iron-isotopic-composition-of-blood-serum-in-anemia-of-chronic-kidney-disease
#7
Yulia Anoshkina, Marta Costas-Rodríguez, Marijn Speeckaert, Wim Van Biesen, Joris Delanghe, Frank Vanhaecke
Chronic kidney disease (CKD) is a general term for disorders that affect the structure and function of the kidneys. Iron deficiency (ID) and anemia occur in the vast majority of CKD patients, most of whom are elderly. However, establishing the cause of anemia in CKD, and therefore making an informed decision concerning the corresponding therapeutic treatment, is still a challenge. High-precision Fe isotopic analysis of blood serum samples of CKD patients with and without ID/anemia was performed via multi-collector inductively coupled plasma-mass spectrometry (MC-ICP-MS) for such a purpose...
April 18, 2017: Metallomics: Integrated Biometal Science
https://www.readbyqxmd.com/read/28412770/anemia-in-chronic-kidney-disease
#8
Meredith A Atkinson, Bradley A Warady
Anemia is common and associated with adverse outcomes in children with chronic kidney disease (CKD). Many factors contribute to declining hemoglobin as CKD progresses, but impaired production of erythropoietin by failing kidneys is a central cause. Hepcidin-mediated iron restriction also contributes to anemia by downregulating both intestinal iron absorption and release of stored iron for erythropoiesis. The core components of anemia management remain erythropoiesis-stimulating agents (ESA) and iron supplementation, but despite these therapies, a substantial number of children remain anemic...
April 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28401160/posttransplant-anemia-as-a-prognostic-factor-of-mortality-in-kidney-transplant-recipients
#9
Maria Majernikova, Jaroslav Rosenberger, Lucia Prihodova, Miriam Jarcuskova, Robert Roland, Johan W Groothoff, Jitse P van Dijk
Background. Findings on the association between posttransplant anemia (PTA) and mortality in posttransplant patients are scarce. This study explored whether PTA shortly after kidney transplantation (KT) predicts mortality at up to 10 years' follow-up, stratified for chronic kidney disease (CKD) stages. Methods. PTA was divided into 3 categories according to the hemoglobin (Hb) value: severe (Hb < 10 g/dl), mild (10.0 g/dl ≤ Hb < 11.9 g/dl), or no PTA (Hb ≥ 12 g/dl). CKD stages were estimated using the CKD-EPI formula and divided into 2 groups: CKD1-2 and CKD3-5...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28389813/plasma-neutrophil-gelatinase-associated-lipocalin-is-associated-with-iron-status-in-anemic-patients-with-pre-dialysis-chronic-kidney-disease
#10
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak
BACKGROUND: Iron deficiency anemia is common in patients with chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of acute kidney injury, is known to be associated with iron metabolism. We investigated whether plasma NGAL level is associated with iron status in pre-dialysis CKD patients with anemia. METHODS: This study included 419 patients who had anemia. The subjects were into categorized into a pre-dialysis group (estimated glomerular filtration rate [eGFR] <60 ml/min/1...
April 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28386819/disease-burden-early-discontinuation-and-healthcare-costs-in-hepatitis-c-patients-with-and-without-chronic-kidney-disease-treated-with-interferon-free-direct-acting-antiviral-regimens
#11
Amy Puenpatom, Michael Hull, Jeffrey McPheeters, Kay Schwebke
BACKGROUND: Hepatitis C virus (HCV) is a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Direct-acting antiviral agents (DAAs) have improved HCV management in CKD patients, however real-world clinical practice data are limited. OBJECTIVE: This study examined the prevalence of CKD among HCV patients receiving oral DAAs in a real-world setting. Comorbidities, early discontinuation rates, and healthcare costs were compared between patients with and without CKD...
April 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28382567/evaluating-risk-factors-for-chronic-kidney-disease-in-pediatric-patients-with-sickle-cell-anemia
#12
Jeffrey D Lebensburger, Gary R Cutter, Thomas H Howard, Paul Muntner, Daniel I Feig
BACKGROUND: Patients with sickle cell anemia (SCA) have an increased prevalence of nephropathy and mortality from chronic kidney disease (CKD). METHODS: We evaluated the association of hyperuricemia and nocturnal hypertension with lower estimated glomerular filtration rate (eGFR) using cystatin-C in patients aged 10-21 years with the HbSS or HbSB0 form of the disease during a non-acute clinic visit. eGFR and uric acid measurements were obtained in 83 and 81 participants, respectively, and 24-h ambulatory blood pressure monitoring (ABPM) was performed in 44 participants...
April 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28372549/the-ferumoxytol-for-anemia-of-ckd-trial-fact-a-randomized-controlled-trial-of-repeated-doses-of-ferumoxytol-or-iron-sucrose-in-patients-on-hemodialysis-background-and-rationale
#13
Iain C Macdougall, Naomi V Dahl, Kristine Bernard, Zhu Li, Alka Batyky, William E Strauss
BACKGROUND: Iron deficiency anemia (IDA) is a common manifestation of chronic kidney disease (CKD), affecting most patients on hemodialysis and imposing a substantial clinical burden. Treatment with iron supplementation increases hemoglobin levels and can reduce the severity of anemia in patients with CKD. While correcting anemia in these patients is an important therapeutic goal, there is a lack of long-term trials directly comparing intravenous iron therapies in patients with CKD receiving hemodialysis...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28371815/phase-2-studies-of-oral-hypoxia-inducible-factor-prolyl-hydroxylase-inhibitor-fg-4592-for-treatment-of-anemia-in-china
#14
Nan Chen, Jiaqi Qian, Jianghua Chen, Xueqing Yu, Changlin Mei, Chuanming Hao, Gengru Jiang, Hongli Lin, Xinzhou Zhang, Li Zuo, Qiang He, Ping Fu, Xuemei Li, Dalvin Ni, Stefan Hemmerich, Cameron Liu, Lynda Szczech, Anatole Besarab, Thomas B Neff, Kin-Hung Peony Yu, Frank H Valone
Background.: FG-4592 (roxadustat) is an oral hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitor (HIF-PHI) promoting coordinated erythropoiesis through the transcription factor HIF. Two Phase 2 studies were conducted in China to explore the safety and efficacy of FG-4592 (USAN name: roxadustat, CDAN name: ), a HIF-PHI, in patients with anemia of chronic kidney disease (CKD), both patients who were dialysis-dependent (DD) and patients who were not dialysis-dependent (NDD). Methods...
March 27, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28343225/clinical-trial-of-vadadustat-in-patients-with-anemia-secondary-to-stage-3-or-4-chronic-kidney-disease
#15
Edouard R Martin, Mark T Smith, Bradley J Maroni, Qing C Zuraw, Emil M deGoma
BACKGROUND: Therapeutic options for the treatment of anemia secondary to chronic kidney disease (CKD) remain limited. Vadadustat (AKB-6548) is an oral hypoxia-inducible factor prolyl-hydroxylase domain (HIF-PHD) inhibitor that is being investigated for the treatment of anemia secondary to CKD. METHODS: A phase 2a, multicenter, randomized, double-blind, placebo-controlled, dose-ranging trial (NCT01381094) was undertaken in adults with anemia secondary to CKD stage 3 or 4...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28339831/safety-of-intravenous-ferric-carboxymaltose-versus-oral-iron-in-patients-with-nondialysis-dependent-ckd-an-analysis-of-the-1-year-find-ckd-trial
#16
Simon D Roger, Carlo A Gaillard, Andreas H Bock, Fernando Carrera, Kai-Uwe Eckardt, David B Van Wyck, Maureen Cronin, Yvonne Meier, Sylvain Larroque, Iain C Macdougall
Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron...
February 27, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28328097/markers-of-iron-status-in-chronic-kidney-disease
#17
REVIEW
Adam E Gaweda
Anemia is one of the main comorbidities related to chronic kidney disease (CKD). Until the advent of erythropoiesis stimulating agents (ESA), endogenous erythropoietin deficiency has been thought to be the main culprit of anemia in CKD patients. The use of ESAs has shed new light on the physiology of CKD anemia, where iron homeostasis plays an increasingly important role. Disorders of iron homeostasis occurring in CKD turn the anemia management in those patients into a complex multifactorial therapeutic task, where ESA and Iron dose must be properly balanced to achieve the desired outcome without exposing the patients to the risk of serious adverse events...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28328083/oral-iron-supplementation-potential-implications-for-the-gut-microbiome-and-metabolome-in-patients-with-ckd
#18
REVIEW
Guus A M Kortman, Dorien Reijnders, Dorine W Swinkels
Patients with chronic kidney disease (CKD) and loss of kidney function are at increased risk for morbidity and mortality. The risks of CKD are attributed to "uremia," an increased concentration of uremic retention solutes (toxins) in the plasma. Recently, a colo-renal axis became clearly apparent and uremia has been associated with an altered gut microbiome composition and metabolism. There is a high prevalence of anemia in patients with CKD, for which patients are often treated with oral or intravenous iron...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28321324/choosing-wisely-the-canadian-society-of-nephrology-s-list-of-5-items-physicians-and-patients-should-question
#19
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28302753/erythropoietin-receptor-mediated-molecular-crosstalk-promotes-t-cell-immunoregulation-and-transplant-survival
#20
Carolina Purroy, Robert L Fairchild, Toshiaki Tanaka, William M Baldwin, Joaquin Manrique, Joren C Madsen, Robert B Colvin, Alessandro Alessandrini, Bruce R Blazar, Miguel Fribourg, Chiara Donadei, Umberto Maggiore, Peter S Heeger, Paolo Cravedi
Although spontaneous kidney transplant acceptance/tolerance occurs in mice and occasionally in humans, mechanisms remain unclear. Herein we test the hypothesis that EPO, a hormone predominantly produced by the adult kidney, has immunomodulating properties that are required for spontaneous kidney graft acceptance. In vitro, in a manner dependent on the EPO receptor and CD131 on antigen-presenting cells, EPO induced the secretion of active TGFβ by antigen-presenting cells, which in turn converted naïve CD4(+) T cells into functional Foxp3(+) regulatory T cells (Treg)...
March 16, 2017: Journal of the American Society of Nephrology: JASN
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